抑郁症患者首次住院后再入院的相关危险因素

Risk Factors Associated with Readmission of First Hospitalized Patients with Major Depressive Disorder

摘要: 目的：探讨影响抑郁症(major depressive disorder, MDD)患者再入院的危险因素。方法：本研究采用回顾性调查的方法，利用电子病历系统(hospital information system, HIS)收集青岛市精神卫生中心2019年1月1日至2019年5月31日首次住院的MDD患者的住院病历信息，以此来探索MDD患者再入院的危险因素。结果：研究共纳入电子病历404份。多因素Logistic回归分析结果显示，精神病性症状、消极观念、白蛋白可能是首次住院的MDD患者发生再入院的独立影响因素。以上三个因素的受试者工作特征曲线(receiver operating characteristic curve, ROC)显示，精神病性症状曲线下面积(area under curve, AUC)为0.576，消极观念AUC为0.579，白蛋白AUC为0.548，三者组合以后，AUC升高为0.655。此外，伴或不伴有精神病性症状、伴或不伴有消极观念、白蛋白指标正常与否的两组间生存时间比较均有统计学差异。结论：伴有精神病性症状、伴有消极观念、白蛋白指标异常促进了首次住院MDD患者再入院的发生。这一结论可能会为MDD患者的治疗与预防提供新的方向。

Abstract: Objective: The study aimed to investigate the risk factors of readmission for major depressive dis-order (MDD) patients. Methods: The risk factors for readmission of MDD patients were explored by retrospective investigation using the Hospital Information System (HIS) to collect inpatient medical records of MDD patients admitted to Qingdao Mental Health Center for the first time between Janu-ary 1, 2019 and May 31, 2019. Results: The study included 404 records. Multivariate regression analysis showed that psychosis symptoms, negative attempts, and albumin may be independent factors of readmission in first hospitalized MDD patients, when other confounding factors are con-trolled. The receiver operating characteristic curve (ROC) for all three factors showed an area under curve (AUC) of 0.576 of psychosis symptoms, negative attempts AUC of 0.579, and an albumin AUC of 0.548, which, when combined, increased to 0.655. In addition, there was a significant difference in survival analysis between the two groups with or without psychosis symptoms, with or without negative attempts, and with or without normal albumin indicators. Conclusions: Psychosis symp-toms, negative attempts, and abnormal albumin markers contribute to readmission in first hospi-talized MDD patients. This finding may provide new directions for the treatment and prevention of MDD patients.